抗リン脂質抗体症候群患者での口腔カンジダ症の経過観察中にAIDSを発症した1例

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  • A Case of Acquired Immunodeficiency Syndrome Diagnosed while Following up Oral Candidiasis with Antiphospholipid Antibody Syndrome

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The patient was a man in his 40s who visited our department with the chief complaint of pain in the oral cavity and discomfort in the tongue. He had a previous medical history of antiphospholipid antibody syndrome （APS） and regularly visited the hematology department of our hospital. As Candida albicans was detected upon an oral bacterial examination and gargling with fangizon was initiated, improvement of symptoms was observed in 1 week. Six months later, recurrence of pain in the oral cavity, body weight loss due to difficulties with oral intake, continuous slight fever, and exacerbation of local symptoms were observed, so he was admitted to the hematology department. HIV-RNA quantification revealed a high level of 7.7×105 copies/ml. Dark brown Kaposi sarcoma （KS）-like lesions were observed on the palate, abdomen, back, and lower limb skin, so a skin biopsy was performed in the dermatology department. Capillary proliferation and spindle cell proliferation were observed with an increased number of human herpes virus 8 （HHV-8） positive cells in an immunohistopathological study. Consequently, a diagnosis of KS was made, leading to a diagnosis of onset of acquired immunodeficiency syndrome （AIDS）. Highly active antiretroviral therapy for AIDS was initiated, leading to improvement of both local symptoms and general condition.

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